News Releases

Wellmark Files Challenge to Certificate of Need Interpretation

Contact:
Angela Feig
515.245.4551
feigab@wellmark.com

(Des Moines, Iowa) – Wellmark, Inc. has asked the Polk County District Court to determine whether the Iowa Department of Public Health correctly interpreted the intent of the Iowa Legislature when it decided that the building of two new hospitals in West Des Moines should be exempt from the public scrutiny required by Iowa’s Certificate of Need law.

The state’s largest health insurer has also requested that the court enjoin Iowa Health – Des Moines and Mercy Medical Center from proceeding with their construction plans to build back-to-back hospitals in West Des Moines until a public hearing is held on whether these hospitals meet the standards set by the Legislature for new hospital construction in Iowa.

The IDPH announced last month that it considered the two hospitals proposed for West Des Moines as just “replacements” for two hospitals on the east side of Des Moines that would be closed, and not as “new” hospitals.

At issue in the lawsuit is what kind of “replacement” can cut off the review by the State Health Facilities Council that the law generally requires for “new” hospital construction.  The Council is charged with assuring that growth and changes in the heath care system occur in an orderly, cost-effective manner and that the services are adequate and non-duplicative.

Wellmark is not opposed to building a new hospital in West Des Moines. With the other hospital closings in Des Moines, Wellmark would likely support a right-sized hospital in West Des Moines, says Wellmark Group Vice President Cliff Gold.

“What we oppose,” he says, “is the building of multi-million dollar hospital buildings without public input through the established process known as Certificate of Need.  We would support any decision made by the State Health Facilities Council in terms of the number of hospitals and number of inpatient hospital beds.”

Gold went on to say that Wellmark believes the public and other interested parties have a right to have a public process to weigh in on all new hospital construction and whether it is needed, or even necessary.  The law’s exemption for “replacement” refers to upgrading an existing structure at the same site, not building two completely new hospitals at new locations, in this case also in another city, says Gold.

Wellmark previously asked both hospital systems to go voluntarily before the SHFC with their separate proposals and let the council determine who should receive a Certificate of Need.  “Wellmark has promised to remain neutral because we trust the SHFC to make decisions that are in the best interest of Iowans and consistent with their charge to ensure cost-effective, affordable health care,” says Gold.  “While Iowa Health agreed to this process, Mercy did not.”

It is Wellmark’s contention that the seeds for a disciplined approach to community-wide health care and hospital facilities planning were planted with an announcement last year by the leadership at Iowa Health – Des Moines and Broadlawns Medical Center. 

These two entities conceived and made public a plan that keeps the county hospital viable by relocating it onto the current campus of Iowa Lutheran Hospital.  Iowa Lutheran then would relocate to West Des Moines.  Under this plan, some $80 million in needed renovations for current Broadlawns would be saved.  Moreover, they were willing to submit their proposals to public scrutiny through the Certificate of Need process.

On the heels of this announcement, Mercy Medical Center made public its intention to close Mercy Capitol Hospital and also build a new facility in West Des Moines.

“We believe public review is critical to ensure that West Des Moines doesn’t end up with two new hospitals that would actually create over-capacity instead of solving that problem by closing Broadlawns and Mercy Capitol,” adds Gold. “It would also meet everyone’s needs – the hospitals, physicians, and the employers and individuals who pay for health care.”

Wellmark, Inc. (www.wellmark.com) does business as Wellmark Blue Cross and Blue Shield of Iowa.  Wellmark and its subsidiaries and affiliated companies, including Wellmark Blue Cross and Blue Shield of South Dakota and Wellmark Health Plan of Iowa, Inc., insure or pay health benefit claims for more than two million customers in Iowa and South Dakota.  Wellmark Blue Cross and Blue Shield of Iowa, Wellmark Blue Cross and Blue Shield of South Dakota, and Wellmark Health Plan of Iowa, Inc. are independent licensees of the Blue Cross and Blue Shield Association.

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Wellmark Blue Cross and Blue Shield is an Independent Licensee of the Blue Cross and Blue Shield Association. Blue Cross®, Blue Shield®, and the Cross® and Shield® symbols are registered marks of the Blue Cross and Blue Shield Association, an Association of Independent Blue Cross and Blue Shield Plans.